Obstetrics and Gynecology Commons^™

Genetic Origins Of Polycystic Ovarian Syndrome (Pcos): An Analysis Of The Genetic Correlation Between Pcos And Insulin Receptor Mutations, Lauren Henry

Undergraduate Theses

Polycystic Ovarian Syndrome (PCOS) remains an extremely common, yet understudied syndrome experienced by 6-12% of females of reproductive age. Not only does it cause painful side effects manifesting both physically and mentally, but it also poses a threat to the fertility of those affected. For this reason, a more in-depth analysis to better understand how to detect this condition early and prevent fertility complications later is certainly warranted. PCOS is suspected to be primarily genetic due to correlations among immediate female family members. Based on previous research, a good starting point for analysis is the INSR gene. Various mutations within …

Identification Of Biomarkers Of Response To Preoperative Talazoparib Monotherapy In Treatment Naïve Gbrca+ Breast Cancers, Xuan Liu, Zhongqi Ge, Fei Yang, Alejandro Contreras, Sanghoon Lee, Jason B White, Yiling Lu, Marilyne Labrie, Banu K Arun, Stacy L Moulder, Gordon B Mills, Helen Piwnica-Worms, Jennifer K Litton, Jeffrey T Chang

Faculty, Staff and Student Publications

Germline mutations in BRCA1 or BRCA2 exist in ~2-7% of breast cancer patients, which has led to the approval of PARP inhibitors in the advanced setting. We have previously reported a phase II neoadjuvant trial of single agent talazoparib for patients with germline BRCA pathogenic variants with a pathologic complete response (pCR) rate of 53%. As nearly half of the patients treated did not have pCR, better strategies are needed to overcome treatment resistance. To this end, we conducted multi-omic analysis of 13 treatment naïve breast cancer tumors from patients that went on to receive single-agent neoadjuvant talazoparib. We looked …

Paradoxical Dat In A Term Newborn With Physiological Jaundice, Abiram Sivanandam, Tomas Rotschild

Rowan-Virtua Research Day

The Direct Antigen Test (DAT) is used to find out if a newborn has maternally-produced antibodies against the newborn’s red blood cells. We discuss the case of a term newborn male with an O+ blood type born to a mother whose blood type is A+. As a part of routine screening, DAT of umbilical cord blood was obtained, which resulted positive. While the neonate had jaundice, the overall clinical picture pointed more toward neonatal physiological jaundice rather than a potential hemolytic anemia expected with a positive DAT. This discrepancy prompted us to review literature to explain our findings.

Bilateral Teratomas In Pediatric Patient With Unilateral Ovarian Torsion, David Ho, Maya Borowczak, Archana Verma

Rowan-Virtua Research Day

Ovarian torsion is a surgical emergency found in both pediatric and adult populations. It involves the full or partial rotation of the vessels that supply the ovary, resulting in ischemia. In this report, we present the case of a pediatric patient arriving to the Pediatric Emergency Department (PED) for evaluation of right lower quadrant (RLQ) abdominal pain, who was found to have an ovarian torsion. In this particular case, the patient’s ovarian torsion was due to a teratoma, and imaging would later identify an additional smaller teratoma on the contralateral side. This case shows the importance of considering ovarian pathologies …

Wernicke’S Encephalopathy Secondary To Hyperemesis Gravidarum, Mohammad Rattu, Alexander Norinsky, James Espinosa, Alan Lucerna, Henry Schuitema

Rowan-Virtua Research Day

Wernicke’s encephalopathy (WE) is a neurological disorder secondary to thiamine deficiency that is precipitated by administration of glucose-containing fluids prior to thiamine supplementation. Though WE is typically diagnosed among alcoholics (12.5%), the prevalence among nonalcoholics can vary from 0.04-0.13%. Around 30-40% of patients with underlying thiamine deficiency will only experience one of the symptoms from the typical triad, with the complete triad (encephalopathy, oculomotor dysfunction/nystagmus, and ataxia) only evident among 5-16% of the population. Among the non-alcoholic patient population presenting with WE, a history of vomiting is more frequent. While nausea affects around 80% of pregnant women, an extreme form …

Effect Of Covid On Postpartum Depression (Ppd), Reshma Thomas, Karen Krieg, Joanna Petrides

Rowan-Virtua Research Day

Purpose:

1. To determine if the rates of postpartum depression have changed during COVID
2. To identify differences in characteristics of women with postpartum depression during COVID

Factors Influencing The Need For And Access To Ivf Treatment, Catherine Alapatt, Yoona Choe, Anthony Knepp, Shika Veera, Shawna M Rotoli

Rowan-Virtua Research Day

Infertility is defined as the inability for a couple to become pregnant after 12 months of regular unprotected sexual intercourse. Infertility can stem from an issue with the female reproductive tract, the male reproductive tract, or both. Individuals struggling with infertility seek medical assistance for a successful reproductive course. However, there are many aspects outside of pathology that may encourage or deter an individual to elect for medical assistance such as in vitro fertilization (IVF). In vitro fertilization is defined as a medical procedure in which an egg is fertilized outside the body. The increased usage of IVF demonstrates the …

Opioid Usage In Pregnant Women, Sheron Mehak, Karen Krieg

Rowan-Virtua Research Day

Women have a heightened sense of health during pregnancy, especially first pregnancies. They often pay closer attention to taking medications (both over the counter and prescribed). Some discontinue smoking and choose healthier diet choices. The question or hypothesis of this research is to examine if this heightened sense of health during pregnancy has any effect on the choice to use recreational drugs during pregnancy.

Foci Of Idc In Phyllodes Tumors: Should We Be Worried?: A Systematic Review Of The Literature, Kathryn Eckert, Victoria Tiedemann, Linda Szczurek

Rowan-Virtua Research Day

Phyllodes tumors are rare, fast growing fibroepithelial tumors of the breast that account for less than 1% of all breast tumors globally. They were first characterized by Johannes Muller in 1838 and most often present in the 5th decade of life. Phyllodes tumors are histologically composed of a stromal component and an epithelial component. The stromal component has a widely accepted malignant potential in up to 30% of cases. Grading of the stromal malignant potential of phyllodes tumors has been defined by the World Health Organization (WHO) as benign, borderline, or malignant based on the presence and degree of stromal …

Screening And Follow Up For Postpartum Depression: How To Improve Practice, Mallory Matusik

Evidence-Based Practice Project Reports

Postpartum depression (PPD) is one of the most common mental health conditions, affecting one in seven women during their reproductive years (American College of Obstetricians and Gynecologists [ACOG], 2018). The purpose of this evidence-based practice (EBP) project was to improve screening and management of PPD using the Edinburgh Postnatal Depression Scale (EPDS) screening tool and a protocol for appropriate treatment and follow up care for PPD. A protocol was created by the project leader with information on screening and diagnosis, follow up, and treatment for PPD. The protocol also included information on how to assess for suicidal and/or homicidal ideation …

Identifying Discrepancies In Diagnosis Of Pcos With Use Of Different Diagnostic Criteria, Naveena Daram, Sangeeeta Kaur

Posters

INTRODUCTION
Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Two main diagnostic criteria are used for PCOS: the Rotterdam and Androgen Excess Society (AES) criteria. Depending on which criteria is used, the diagnosis of PCOS may change. Therefore, our study investigates the discrepancies in the diagnosis of PCOS when using the Rotterdam versus the AES scale in the Beaumont Health System. This is clinically significant because a PCOS diagnosis should not be made lightly as it can come with many lifelong social, emotional, and medical implications.

Vbac Success In Women With Diabetes Mellitus Types I + Ii: A Pilot Study, Emma Randall, Rachel Taylor, Sarah Becker, Zeynep Alpay-Savasan

Posters

Due to a rise in cesarean sections since the 1970s, the American College of Gynecology has acted to reduce unnecessary cesarean deliveries. In 2017, ACOG released clinical management guidelines for vaginal birth after cesarean delivery (VBAC), including a nomogram to predict VBAC success. This nomogram, developed by Grobman et al. (2007), explored factors impacting VBAC success for delivery at term for a singleton pregnancy. While the presence of diabetes was evaluated in the study, it was not found to be a significant factor in predicting outcome. This study will take a more detailed look at if pre-existing diabetes impacts a …

Effectiveness Of Prenatal Screening Tests On Predicting Cardiac Anomalies, Stephanie Y. Wong, Zeynep Alpay Savasan

Posters

INTRODUCTION
Congenital heart disease (CHD) is the leading cause of birth defect-associated infant death. With 1 in 111 newborns born with CHD and an elevated infant mortality rate of 30-50%, early detection is imperative. Current prenatal screening mainly focuses on detecting chromosomal anomalies. However, the accuracy of these exams on detecting fetal cardiac abnormalities is not well researched. The primary goal of this study is to compare three prenatal screening tests’ potential, i.e anatomy ultrasound, nuchal translucency (NT), and cell-free DNA (cfDNA), in identifying risk for fetal cardiac anomalies.

Descriptive Causes For Decreased Breast And Cervical Screenings In Sikh Populations, Varneet Kaur Brar

Posters

INTRODUCTION
Prior evaluations of breast and cervical cancer screens have found that immigrant South Asian women have lower compliance rates when compared to non-immigrant, white, or African American women (Shoemaker, 2016). It is widely accepted that early detection of cancers can improve outcomes for patients, and that screenings like mammography and pap smear tests are critical in this process. The aim of this study was to evaluate compliance rates for breast cervical cancer screens in Sikh women in Michigan, as well as to investigate attitudes which may be contributing to any disparities which may exist.

Effects Of Increased Levels Of Relaxin Hormone In Women During Pregnancy In Relation To Spondylolisthesis: A Literature Review, Joselin R. Guerrero Rapalo

Honors Theses

No abstract provided.

A Community-Based Approach To Cervical Cancer Prevention In Western Kenya: An Ampath Feasibility Project, Elkanah Omenge, Philip Tonui, Kapten Muthoka, Stephen Kiptoo, Titus Maina, Mercy Agosa, Aaron Ermel, Yan Tong, Darron Brown

Obstetrics and Gynaecology, East Africa

Objectives: Centralized programs have been ineffective in reducing the burden of cervical cancer among Kenyan women. A community-based pilot study was initiated to screen Kenyan women for cervical cancer and to vaccinate their children against human papillomavirus (HPV).

Methods: Women were educated about cervical cancer prevention at community meetings. Women then provided self-collected vaginal swabs for oncogenic HPV testing using the Roche Cobas Assay. All women were then referred to the local clinic for Visual Inspection with Acetic Acid (VIA). Women were offered the quadrivalent HPV vaccine for their children if and when it became available for the …

Determinants Of The Uptake Of Prenatal Aneuploidy Screening Among Pregnant Women At The Aga Khan University Hospital, Nairobi, Kenya, Duncan Ndegwa

Master of Medicine in Obstetrics and Gynecology

INTRODUCTION: Aneuploidies present with an abnormal copy number of chromosomes. Majority are lethal with only a handful carrying on to term and beyond in pregnancy. Its currently recommended that all pregnant women be offered screening for aneuploidies. This is to facilitate pregnant women make informed choices regarding their pregnancies. At present the current uptake rate of aneuploidy screening in Kenya is unknown. The purpose of this study this study was to determine whether pregnant women are aware of aneuploidy screening, the uptake rate of screening and the determinants of screening at a tertiary private healthcare facility in Nairobi, Kenya. METHODS: …

Association Between Third Trimester Cerebro-Placental Ratio And Adverse Outcomes In Appropriate For Gestational Age Foetuses, Morris Wabacha Kimani

Master of Medicine in Obstetrics and Gynecology

Background: Small for gestational age (SGA) fetuses are at increased risk of adverse outcomes and appropriate vigilance is put in place in terms of antenatal and intrapartum surveillance. Appropriate for gestational age (AGA) fetuses have a lower incidence of adverse outcomes, although majority of these outcomes occur in this cohort. AGA fetuses can fail to reach their genetic growth potential due to placental insufficiency and 25 % have actually been found to have placental histological features of chronic hypoxia. Therefore, there is need to use other methods of screening for adverse perinatal outcomes apart from estimated fetal weight (EFW), with …

Increasing Patient Satisfaction Of Post-Cesarean Mothers: An Evidence-Based Practice Quality Improvement Project, Amanda Jones

DNP Projects

Introduction: The first hour after delivery, referred to as the “Golden Hour” or “Sacred Hour,” is when the mom, baby, and the support person get 1-hour of uninterrupted bonding time together. This time is critical because it promotes neonatal thermoregulation, decreases newborn stress levels, improves mother–newborn attachment, and encourages breastfeeding. Unfortunately, most cesarean births do not receive the Golden Hour and instead experience delayed bonding time.

Purpose: The purpose of this Evidence-Based Practice (EBP) project was to incorporate the Golden Hour for post-cesarean section mothers in a mid-sized community-based hospital in XXX, CT in order to increase patient satisfaction post-c-section; …

The Effects Of Hormonal Contraceptive Use On Perceptions Of Social Stress In Women, Ashton Jones

Biological Sciences Undergraduate Honors Theses

Hormonal contraceptives are widely used due to their efficiency in preventing pregnancy. Although women are often informed of the physical effects of hormonal contraceptives, there is little emphasis on mental effects, such as increased rates of depression and changes in social perception. The current study examined perceptions of social stress among women before beginning hormonal contraceptives, and two months after using hormonal contraceptives. I hypothesized that women would experience increased social stress after beginning hormonal contraceptives, compared to a control group of women who were also assessed twice. Results did not support this hypothesis; there was no difference in interpersonal …